Will Sofosbuvir/Ledipasvir (Harvoni) Be Cost-Effective and Affordable for Chinese Patients Infected with Hepatitis C Virus? An Economic Analysis Using Real-World Data

Guo-Feng Chen, Lai Wei, Jing Chen, Zhong-Ping Duan, Xiao-Guang Dou, Qing Xie, Wen-Hong Zhang, Lun-Gen Lu, Jian-Gao Fan, Jun Cheng, Gui-Qiang Wang, Hong Ren, Jiu-Ping Wang, Xing-Xiang Yang, Zhan-Sheng Jia, Qing-Chun Fu, Xiao-Jin Wang, Jia Shang, Yue-Xin Zhang, Ying Han, Ning Du, Qing Shao, Dong Ji, Fan Li, Bing Li, Jia-Liang Liu, Xiao-Xia Niu, Cheng Wang, Vanessa Wu, April Wong, Yu-Dong Wang, Jin-Lin Hou, Ji-Dong Jia, Hui Zhuang and George Lau

PLOS ONE, 2016, vol. 11, issue 6, 1-13

Abstract: Background: Little is known on the cost-effectiveness of novel regimens for hepatitis C virus (HCV) compared with standard-of-care with pegylated interferon (pegIFN) and ribavirin (RBV) therapy in developing countries. We evaluated cost-effectiveness of sofosbuvir/ledipasvir for 12 weeks compared with a 48-week pegIFN-RBV regimen in Chinese patients with genotype 1b HCV infection by economic regions. Methods: A decision analytic Markov model was developed to estimate quality-adjusted-life-years, lifetime cost of HCV infection and incremental cost-effectiveness ratios (ICERs). SVR rates and direct medical costs were obtained from real-world data. Parameter uncertainty was assessed by one-way and probabilistic sensitivity analyses. Threshold analysis was conducted to estimate the price which can make the regimen cost-effective and affordable. Results: Sofosbuvir/ledipasvir was cost-effective in treatment-experienced patients with an ICER of US$21,612. It varied by economic regions. The probability of cost-effectiveness was 18% and 47% for treatment-naive and experienced patients, and it ranged from 15% in treatment-naïve patients in Central-China to 64% in treatment-experienced patients in Eastern-China. The price of 12-week sofosbuvir/ledipasvir treatment needs to be reduced by at least 81% to US$18,185 to make the regimen cost-effective in all patients at WTP of one time GDP per capita. The price has to be US$105 to make the regimen affordable in average patients in China. Conclusion: Sofosbuvir/ledipasvir regimen is not cost-effective in most Chinese patients with genotype 1b HCV infection. The results vary by economic regions. Drug price of sofosbuvir/ledipasvir needs to be substantially reduced when entering the market in China to ensure the widest accessibility.

Date: 2016
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0155934

DOI: 10.1371/journal.pone.0155934

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